| Rise Therapy Lcsw Pc | |
|
1660 Route 112 Ste B Port Jefferson Station NY 11776-8057 | |
| (631) 253-8512 | |
| Not Available |
| Full Name | Rise Therapy Lcsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1660 Route 112 Ste B, Port Jefferson Station, New York |
| Authorized Official Name and Position | Elizabeth Pace (OWNER) |
| Authorized Official Contact | 6312538512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rise Therapy Lcsw Pc 1660 Route 112 Ste B Port Jefferson Station NY 11776-8057 Ph: (631) 253-8512 | Rise Therapy Lcsw Pc 1660 Route 112 Ste B Port Jefferson Station NY 11776-8057 Ph: (631) 253-8512 |
| NPI Number | 1225749195 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 12/12/2022 |
| Certification Date | 12/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225749195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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